[Long-term curative effects of suture plus proximal gastric vagotomy or triad-therapy for duodenal ulcer with acute perforation] [Results of pre- and postoperative treatment of complicated duodenal ulcers with proton pump inhibitors ] Rx drugs

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A method for simultaneous phenotyping and genotyping for CYP2D6 and CYP2C19 was tested. Six healthy volunteers were selected (three extensive and three poor metabolisers for CYP2D6). CYP2D6 was probed with dextromethorphan and metoprolol and CYP2C19 was probed with omeprazole. Blood samples were collected and analysed for dextromethorphan, dextrorphan, metoprolol, alpha-hydroxymetoprol, omeprazole and 5-hydroxyomeprazole by HPLC. Genotyping was performed for both CYP2D6 and CYP2C19. Generally, plasma levels could be measured up to 8 h post-dose except for alpha-hydroxymetoprolol in poor metabolizers (PMs) and dextromethorphan in extensive metabolizers (EMs) (35% below quantification limit). The correlation between the metabolic ratio based on timed individual measurements and the metabolic ratio based on the AUC0-12 values was significant at 3 h post-dose for all probes. In conclusion, the following procedure is suggested: administer metoprolol (100 mg) and omeprazole (40 mg); after 3 h, take a blood sample to assess the genotype and the metabolic ratio for CYP2D6 (metoprolol over alpha-hydroxymetoprolol) and CYP2C19 (omeprazole over 5-hydroxyomeprazole) in plasma. With this procedure, all necessary information on the individual CYP2D6 and CYP2C19 metabolising capacity can be obtained in a practical, single-sample approach.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11417446&dopt=Abstract

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Zhonghua Wai Ke Za Zhi. 2002 Sep;40(9):647-9.
[Long-term curative effects of suture plus proximal gastric vagotomy or triad-therapy for duodenal ulcer with acute perforation]

[Article in Chinese]

Xu R, Fang L, Jiang X, Wan Y, Huang S, Jiang K, Lin N, Pan W.

Department of General Surgery, Third Hospital of Sun Yat-Sen University, Guangzhou 510630, China.

OBJECTIVE: To study the long-term curative effects of suture plus proximal gastric vagotomy (PGV) and suture plus triad-therapy (omeprazole, amoxycillin and flagyl taken orally) for the treatment of duodenal ulcer with acute perforation. METHODS: Three hundred and twenty-nine patients with duodenal ulcer and acute perforation were treated with 2 different methods, respectively. Method A was suture plus PGV (group A, 153 cases), and method B was suture plus triad-therapy (group B, 176 cases). Follow-up was made by means of correspondence, outpatient reexamination and cooperation with local hospitals in 5 to 8 years after operation. The contents of follow-up included symptom acquisition (such as upper abdominal pain or distention, pyrosis, belch, acid regurgitation, vomiting, diarrhea and conditions of living or working), gastroscopy and Helicobacter pylori (HP) detection. The curative effects were evaluated by the Visick scale. RESULTS: Three hundred and one patients were followed up (group A 142 and group B 159). According to the Visick scale, 97 (68.3%), 19 (13.4%), 13 (9.15%) and 13 (9.15%) patients in group A, and 31 (19.5%), 28 (17.6%), 24 (15.1%) and 76 (47.8%) in group B were classified as Visick I, II, III and IV respectively (Z = -9.818, P < 0.01). As for HP detection, there were 130 (91.5%) patients in group A and 94 (59.1%) in group B (chi(2) = 41.438, P < 0.01). CONCLUSIONS: The long-term curative effects of suture plus PGV were superior to those of suture plus triad-therapy for duodenal ulcer with acute perforation although HP positive rate was higher in group A than in group B. HP infection is one of the etiological factors of duodenal ulcer. The increased excitability of the vagus nerve remains to play an important role in duodenal ulcer.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12411130&dopt=Abstract

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Klin Med (Mosk). 2002;80(9):52-4.
[Results of pre- and postoperative treatment of complicated duodenal ulcers with proton pump inhibitors ]

[Article in Russian]

Cherniakevich SA, Babkova IV, Mikhalev AI.

Benefit of monotherapy of duodenal ulcers by lanzap in 36 patients was compared to that of combined therapy including panitidin in 26 patients. Lanzap brought about ulcer healing within 7-10 days in 55.6%, within 14-16 days ulcer scarring was observed in 35 patients (97.2%). Ulcer healing progressed depending on ulcer size. Combined treatment with ranitidine promoted ulcer scarring in 14-16 days in 73% patients. Lanzap monotherapy in preoperative period promoted fast healing of ulcer defect anf provided optimal conditions for surgery.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12416227&dopt=Abstract

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